The model trends in the healthcare system have been changing over the period of time. The old trend gave importance to the individual patients and the emphasis was on treating illness. The goal of the hospitals was to do inpatient admissions, fill up the beds and more emphasis was given to acute inpatient care. The role of managers in the old paradigm was to run the organization and coordinate services. In the old system, all providers were essentially the same. The hospitals, physicians and health plans were separate and not integrated.The newer trends that evolved gave importance to the population as a whole. It not only treated illness, but emphasized on promoting the wellness of the people. The goals of the healthcare system after being transformed over the years is to provide care at all levels which is continued. The role of managers in the new paradigm is more broad. They see the market and help in quality and continued improvement. They not only run the organization, but also go beyond the organizational boundaries. In the evolving system, the providers are differentiated according to their ability. The hospitals, physicians and health plans have formed an integrated delivery system.One of the current trend in the healthcare delivery model is that continued care is emphasized. The key professionals are not only treating patients for their illness, but they are promoting and managing quality of health. For example, a patient with high cholesterol visits a doctor. He is not only given one-on-one medical treatment, but he is also offered to attend a group session where information is provided on how lifestyle and behavioral change can help. The patients learn from the clinicians and also from each other. Another current trend is to take care of the health of the defined population and not only individual patients. All the health needs of the population as a whole are identified and served. It is emphasized that the community uses the health and social services provided. Healthcare has become more population-based. Another trend that has evolved is that the hospitals, physicians and health plans have got connected and have formed an integrated delivery system. More investments are being made with a goal of providing services to the customers and retaining them.There is a beneficial impact in the transformation of healthcare towards emphasizing continued health. The way healthcare has been viewed in the past has been changing. The shifting of care from treating acute illnesses to providing continued care is resulting in enhancement of the health of the people. The only appropriate and feasible model is to provide a continuum of care with the emphasis firmly on the family and community. The health of the population and community is considered as a whole. This is advantageous as it creates value in the healthcare delivery system. The healthcare providers work with the community as a whole and consider to improve the health of the general population. Even though this requires new kinds of ways of organizing and managing healthcare services, it helps in understanding the health needs of the target population. By studying their needs, the right health and social services could be provided to them. Examples of promoting wellness of the whole community are organizing health campaigns and providing preventive education to the people in general. Another example is providing awareness about flu vaccines and encouraging people to get the vaccination.Integrating the healthcare delivery system has led to certain advantages to the patients. For example, they can be offered alternative sites of care depending on their convenience. It helps in meeting the needs of the customers and their preferences which is taken into account. The number of providers are expanded and the patients get to have a choice. The relationship between providers and health plans are organized in the current trend and this ensures that the right care is provided in a convenient way to the customers.There are defined budgets and expenditure targets for the populations which implies that there is a need to be efficient and productive. The formation of strategic alliances, networks, systems and physician groups can also add value. There are capitated payments and budgets allotted to the healthcare organizations. These are used to provide care to the defined population. The organization might like to improve on the payments and budgets as the expenditures of the companies increase. This results in the management to make decisions like forming strategic alliances with other organizations and increase the total resources. The growth of such networks will help in providing better care to the customers. Financial resources greatly influence the efficiency and productivity of the organization.The aging population is influencing the healthcare delivery. There is increased demand for primary care of people over 65 years and for chronic care of people over 75. The ethnic and cultural diversity is also influencing the healthcare delivery. This provides a challenge in meeting patient expectations on one hand and diverse workforce on the other. Biological and clinical sciences have met with technological advances and have led to new treatment modalities. This has led to open new treatment sites and manage across the organization. External forces change the supply of certain areas of health professionals like physical therapy and some areas of nursing. The management needs to compensate for such shortages and they need to develop different teams of caregivers at different work sites. Changes in education of health professionals implies that the management be more creative in offering healthcare services. With an increase in diseases like AIDS and morbidity from drugs and violence, there is more and more need to work with community agencies, form social support systems and there is a need for more chronic care management. Advances in information technology is another area where there is a need to train the healthcare employees in new advances. They also need to manage issues of confidentiality and rapid information transfer. Increasing expansion of world economy has led to more competitive management of strategic alliances, care of patients across the nations and of different cultures.Current environmental trends impact the healthcare delivery model. Organization’s success depends on its external and internal environment. The complex environments made up of uncertainties and heterogeneity of components leads to different organizational designs. The current environmental trends influence managerial and organizational decision making. The unique challenges facing the healthcare delivery organizations should be analyzed in order to develop and implement new and effective operational processes and strategies. As an impact of current environmental trends, the healthcare delivery system needs to improve individual, team, and organizational accountability and performance. The impact of advances in medical knowledge and information technology on the process of healthcare delivery should also be examined, and it should be leveraged to improve quality of care, process and cost controls, and revenue. New strategies would need to be identified and implemented for learning and performance improvement to create a culture that supports accountability, safety, and high-quality care. Innovative models in healthcare delivery would also be required in order to develop and implement strategies that promote organizational success and competitiveness.Due to the current environmental trends, more emphasis is given to the customers and there is more of a patient-focused care. The healthcare delivery model has been shifting to the community based care. There has been an increased modification in care processes. The traditional ways are being challenged and more experiments are being performed to fulfill the demands to improve the quality of care. Due to the shift in the environmental trends in the healthcare delivery model, more emphasis is given to quality improvement. This will help improve the performance levels of key processes in the organization. The performance levels are being measured, the defects are eliminated and new features are being added to meet the customer’s need efficiently.There is a new emerging contemporary trend in the U.S. healthcare system. Presently, the management research and assessment have been offered increased recognition. The emerging trend seen is that this is slowly forming an integral part of managerial and organizational effectiveness. With the emerging efforts in information management, it is leading towards clinical and financial networking. The trend seen among the physicians and nurses is that they are being increasingly involved in managerial activities. The managerial trends are also changing with respect to role performance and changing values. The managers role is getting more and more recognized in managing finance and human resources. Management training, lifelong and distance learning is being offered in preparing future managers.The healthcare executives and managers will be faced with the major responsibility and challenge in the years ahead. They will be working with other healthcare providers and will be creating a competitive future for their organizations. They will not only be managing organizations but also a network of markets, services and joint ventures. Formation of more and more strategic alliances and partnerships will lead the management to manage across boundaries. The management will change from managing a department to managing the continuum of care. The management will be following a community-based approach. Trend in management is also shifting from just coordinating services to providing improvements in quality.As the demands in healthcare are increasing, the management is responsible for forming performance standards. The management is also challenged to maximize the productivity and quality to serve the health needs of the community. The management is looking after the demands of the external environment as well as attending to the performance of the internal environment. The management is responsible for the performance of the organization.Healthcare organization leadership will be responding to new trends and competitive forces. It will respond to continuum of care, overall health status of the population and more complex organizational structures. These emerging trends in the healthcare system will effect the organization’s leadership. The future managers would need leadership skills and vision to integrate the organizations and help in providing the best care. The managers will have to be committed to leadership and work on giving their organizations the best place and help their organizations adapt to the changing circumstances. More value will be given to leaders who will be able to lead the change process. As changes are inevitable for the betterment of the organization, the leaders should be able to identify how the change is to be received and how it is to be communicated at all levels of the organization without damaging the implementation process. The leaders might have to deal with increased pressures due to organizational complexity.The leader in the organization provides strategic direction to the organization, manages diverse stakeholders, becomes mentors for management, is willing to take risks, helps the organization interact with the external environment and attends to the internal needs as well. Where required the leader will involve physicians in governance process and align physician and organizational interests. There will be a need for formation of learning organizations. Transformational leadership will create the required vision for the organization. Leaders will have a greater role complexity and they themselves will have to adjust rapidly to new situations. The healthcare organization leadership will have to live up to the values of the organization and will help in fulfilling the mission of the organization.Individuals and groups within the healthcare organizations require more and more competencies. An enhanced lifelong learning is required due to the fast, changing environment. The individuals and groups within the healthcare organizations will be benefitted as there will be rapidly developing medical technologies which will result in increased services. More sophisticated health services will be provided to the consumers. The range and quality of services provided will be regulated for the benefit of people requiring home care, long term care and ambulatory care. The anticipated future development will also result in the increased competition among the health services organization. The individuals and groups will be involved more and more with the community for issues like drug abuse, teenage pregnancy and violence.Individuals and groups will be faced with increased strategic planning and management in the healthcare organizations as there will be ever increasing involvement by the trustees and physicians. As the future environment in the organizations will be more complex, the individuals and groups in the healthcare organizations might feel more pressurized. They will need to serve the changing demands of the community as the population of elderly patients will increase. These individuals will require more professional training, increased levels of education and should be taking part in continuing education programs.Due to the anticipated future development in the healthcare organizations, those individuals and groups will be valued, who are adaptable, committed, are able to add value and embrace change. These individuals will be required to experiment more and help in redefining the mission and goals of the healthcare organizations.
Miscellaneous Supplements – Sports
Structured Lipids- Increased Protein SynthesisAdvances in the technology behind lipid synthesis led to the development of structured lipids (SLs). A structured lipid (SL) is a triglyceride that includes both medium (8-12 carbons) and long-chain fatty acids (14-22 carbons) within the same triglyceride. Emulsions including SL have demonstrated increased protein synthesis and increased nitrogen balance (NB) in burned animals The SL has also been superior to medium-chain triglyceride (MCT) and long-chain triglyceride (LCT) emulsions in stimulating muscle protein synthesis in animal studies.The use of SLs has been primarily limited to clinical and experimental settings whereby it has become necessary to develop medical nutrition therapies that minimize the adverse effects of high lipid feedings and maximize the positive outcomes. Such positive outcomes include increased protein synthesis, enhanced immune function, decreased risk for cardiovascular disease, and improved glucose homeostasis. The ability to increase protein synthesis, maintain the health of the immune system, and stabilize blood glucose are factors that can also play a role in improving athletic performance. Research on the application of this clinical technology to athletic performance is not available at this time.Peptides- To Provide Glutamine to TPN PatientsIn an effort to provide glutamine to TPN patients in a form that can remain stable in liquid, the amino acid has been bonded with other amino acids, such as the dipeptide alanyl-glutamine. This combination can preserve muscle glutamine levels and muscle protein synthesis after surgery and improve whole-body nitrogen balance. This finding is supported by research on rats with peritonitis Alanylglutamine increased protein synthesis in the liver and skeletal muscle, protected the morphology of the intestinal mucosa, and improved survival in protracted bacterial peritonitis. The researchers concluded that alanylglutamine supplementation may be useful in septic patients.Role of Glutamine as Glucose RegulationThe role of glutamine regarding glucose regulation may be important in exercise-trained individuals. Its function in gluconeogenesis (formation of glucose) and glycogen repletion may serve as a useful function during and after exercise. Gluconeogenesis from glutamine can occur without changes in plasma insulin and glucagon levels, providing evidence that glutamine itself can regulate gluconeogenesis.Nurjhan et al. compared the contribution of alanine and glutamine to glucose formation in postabsorptive (fasted) normal human volunteers and found that the amount of glucose carbon that came from proteinderived glutamine was 100% greater than from alanine. Varnier et al. studied the effects of glutamine, alanine plus glycine, and saline infusion on glycogen accumulation in subjects who cycled for 90 minutes. Two hours postexercise, glutamine infusion resulted in a twofold greater concentration of muscle glycogen than either saline or alanine plus glycine infusion. In postabsorptive humans, glutamine could be more important than alanine for glucose formation derived from proteolysis. Further, glutamine carbon can be directed to glycogen accumulation in skeletal muscle that had been previously glycogen depleted.In mice that were genetically predisposed to being overweight and hyperglycemic, the administration of glutamine in conjunction with a high-fat diet resulted in a reduction of body weight and a drop in hyperglycemia and hyperinsulinemia. The mechanism for a glutamineinduced weight reduction is not known, though it may be related to the ability of glutamine to lessen the insulin resistance induced by a high-fat diet. Further, the administration of glutamine to lipid-based TPN can prevent glucose intolerance and insulin resistance.
Eliminating Profit Robbing Telemarketing Calls to Your Business
Most of us small business owners don’t have the luxury of having a secretary or office manager to screen our calls for us. It can become overwhelming when answering sales call after sales call from telemarketers prevent us from doing what makes us money. To top it off, we can sometimes be talked into spending our hard earned money on products or services that are often overpriced and/or not needed in the first place.Each time we add a new business telephone number or change the business location of the ones we currently have, our telephone numbers are placed on a telemarketing list as a “new business.” Our business phone lines are then overrun by harassing telemarketers that want to be the first to sell a new business what they don’t need. You see a “new business owner” generally hasn’t fine tuned their decision making skills to the point that they can just say no and hang up. These skills come with time and experience. Telemarketers know this and target these new business owners because seasoned owners won’t fall for their tactics.I am always adding or changing toll free and regular phone numbers. To prevent this constant barrage of calls (I call it “the first wave”) or to at least limit them, I have developed a strategy that is working right now. You, as a small business owner, can take what you need from this and add to it your own ideas that you have found that work.First, the “Do Not Call” list! This list was set up for consumers and not businesses. We as consumers are afforded a lot more rights under the law than we are as business owners. Either way there is no mechanism the government can use to determine whether the number you put on the list is a business number or a residential number. I am not telling you to put your company’s number on the list. I am simply explaining that if you did, it would work. Any number that is put on this list almost instantly sees a drop in calls from telemarketers. You can find this list by doing a search for “do not call list” on your favorite search engine.Secondly you must accept the fact that if you need something for your business then you will seek it out and find it yourself! Train yourself to never buy “spur of the moment!” Spontaneous purchases can kill a business. Once you realize this then you will never change your phone service just because someone called and was nice to you. You’ll never buy twelve dozen light bulbs or two thousand feet of extension cord. If you need a first aid kit then go buy one at the Home Depot and don’t buy a dozen from a con man on the other end of the phone. First aid kits, extension cords, light bulbs and phone service are all the top sellers to the construction business, your industry may differ but I am sure not by much. You must say no and it is absolutely OK to be rude and to hang up mid sentence. The point is that once you have trained yourself to say “no,” then you can follow step three.Third, you must tell the caller that not only are you not interested but you want them to remove your company and phone number from their list. You must do this every time.
Watch out for “free” items, “we want to save you money” or “can I ask you why” because these are their favorite tricks to get you to spend. I try to be as polite as I can so that they will actually remove my phone number. Sometimes you may need to call an 800 number that they will give you in order to be removed from further solicitation. I recommend that you call and have your business’ phone number removed right away because these companies can actually sell your name to other companies as an “active” number and that will only make matters worse. The problem then spreads like a virus. The bottom line is to tell them no and to ask them to remove you from their list before you even hear what they have to offer.Another way that I minimize the distractions of telemarketing sales calls is to use caller ID. Unfortunately, only local companies that acquire work locally can utilize this method. My concrete cutting company services customers in Massachusetts, New Hampshire and Maine, so when I get a call from California or some odd area code, I will prepare myself to be firm and up front before I answer the phone. If my calls are forwarded to my cellular telephone and I find out the call wasn’t from a vendor or supplier then I will simply program the number as DNA into my cell phone. This stands for “Do Not Answer!” You can program up to ten numbers under one contact name in most cellular phones and give it a distinct ring tone. I have DNA1, DNA2 and so on and I am up to DNA9 right now. If I see or hear one of these numbers come in I just push the button that sends them directly to voice mail.Lastly and very important is the use of a device that is called the “TeleZapper.” The TeleZapper sends a digital tone through the phone line telling automatic dialers used my many telemarketers that the line is currently disconnected and or not in use. The automatic dialing computer subsequently removes your phone number from its list. This not only stops them from calling back it also prevents them from selling your phone number as an “active number.” This device became almost extinct once the “Do Not Call” list became a reality because who needs to “zap” a telemarketer if you are not getting any calls? It still works great for the small business and you will see a dramatic drop in telemarketing calls if you use it correctly. This device will not work if you forward your calls to another phone or if you use a voice mail provided by your phone company and your calls are sent to that voice mail box. It will work when a call is picked up by an answering machine in your office. The TeleZapper is very difficult to find anymore in retail stores but it is still readily available new on eBay or online.© 2007 Affordable Concrete Cutting Massachusetts, MA All Rights Reserved